Happy Medic Article - GCS Calculation / Refusal

Attempted robbery

GCS 15/14 depending on if you would constitute his speaking as confused. I can still understand what he's saying, but he goes back and forth.

Don't know if he's competent to refuse... not enough info, no AO score, etc etc

Probably IS his normal mentation as I wouldn't be surprised if he's on alcohol, drugs, or fell down a thousand times as a kid.

Probably alcohol/marijuana





Now where's my cookie?
 
1. Attempted robbery

2. Seems to coherently remember the events, hence 15.

3. If he's alert, orientated to person/place/purpose/time, can understand the risks of refusing treatment and is competent (e.g. not under the influence, however 1 beer is not "under the influence," but competent can include other issues besides substance abuse), then yes. If he's not, then no. The problem I see is his language. Is this his normal word choice and verbal style or is it significantly influenced by substance use? Just because someone talks strangely doesn't mean he is or isn't competent. Location, socioeconomic class, education, and plenty of other intangibles will affect these. Heck, if we want to go by word choice, I'd argue that most people who post on EMS forums are not competent to refuse care, little less render it.


4. Could this be his normal mentation? Yes. Could this be abnormal? Yes.

5.Alcohol, THC, glue.
 
I call him 15. I wouldn't call him confused. I think it is a combination of a southern accent, chewing tobacco, and poor education.

So far he hasn't done anything to convince me he's not competent, but it is hard to tell without actually talking to him.

As for potential intoxication my guesses are alcohol, marijuana and painkillers, in order of likelihood.
 
Well his GCS isint low enough for me to pump drugs into him and shove a tube down his gob.

I wouldn't feel bad if he didn't my help.
 
I think this is a good exercise. Too bad we don't see more of these.

1. What happened? Robbery
2. What is this man’s GCS score? 15
3. Is he competent to refuse transport in your jurisdiction? Yes. Why or why not? Although he displays signs of intoxication, he is alert, aware of what happened, and may be able to make an informed decision regarding transport. Further discussion is needed with PT to make an official call.
4. Could this be his normal mentation? He may be under the influence of a controlled substance, but I'm afraid that his presentation may not be too far from his baseline.
5. If not, what would you suspect a person who presents like this actor acted to be under the influence of? Alcohol and maybe a Vicodin
 
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I'm afraid that his presentation may not be too far from his baseline.
Click to expand...

That's what I was thinking.




Well ... that, and that he's probably from North Carolina. :sad:
 
Good thoughts here!

I say the same, 14-15.

He's aware to the events that just happened, which is great.

I'd probably ask him a few questions about his injuries and then explain to him why I feel he should see a doctor. I'd then make him aware of the risks of not seeing a doctor and if he were able to repeat those risks back to me I'd call medical command and relay the report.
 
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